The immediate effect of aerobic exercise on haemostatic parameters in patients with recently diagnosed mild to moderate essential hypertension |
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Authors: | John Lekakis Helen Triantafyllidi Vasiliki Galea Matina Koutroumbi Theodoros Theodoridis Christoforos Komporozos Ignatios Ikonomidis Vasiliki Christopoulou-Cokkinou Dimitrios Th Kremastinos |
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Institution: | (1) 2nd Cardiology Department, Attikon Hospital, Medical School, University of Athens, 83, Agiou Ioannou Theologou, Holargos, Athens, 155 61, Greece;(2) Haematology Laboratory, Evangelismos Hospital, Athens, Greece |
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Abstract: | Background Exercise is frequently recommended for the treatment of patients with arterial hypertension. Previous studies have shown an
enhanced coagulation state after exercise. Our study investigates the alterations observed after a single session of submaximal
aerobic exercise concerning coagulation, fibrinolysis, platelet activation as well as endothelial function in patients with
recently diagnosed essential hypertension.
Methods Twenty non-diabetic patients with recently diagnosed essential hypertension participated in a 45 min submaximal exercise test
on a bicycle ergometer. Blood samples were drawn before and after exercise in order to determine parameters of coagulation
activation (Prothrombin time PT], activated Partial Thromboplastin time aPTT], fibrinogen, D-Dimers, prothrombin fragments
1 + 2 PF1+2], thrombin-antithrombin III complex TAT] and factors VII, VIII and XII), platelet activation (Platelet count,
Platelet factor 4 PF4] and β-thromboglobulin β-TG]), fibrinolysis activation (Plasmin-a2 antiplasmin complex, PAP) and endothelial function (soluble Thrombomodulin sTM] and von Willebrand factor vWf]). Soluble
P-selectin served as a marker for endothelial and platelet activation.
Results All patients completed the exercise test. aPTT (P < 0.001) and factor VII (P = 0.01) significantly decreased while PT (P = 0.04), fibrinogen (P = 0.008), factor VIII (P < 0.001), platelet count (P = 0.002) and β-TG levels (P = 0.01) significantly increased as a result of exercise. Compared to baseline there was an 11% increase in TAT (P = 0.04) and a 28% increase in PAP (P < 0.001) at peak exercise. One hour post exercise, there was a 43% increase in PAP whereas TAT levels became similar to those
at baseline. Additionally vWf (P = 0.01) and sP-selectin (P = 0.02) levels significantly increased throughout the exercise protocol.
Conclusions Patients with recently diagnosed and never treated mild to moderate essential hypertension undergoing submaximal aerobic exercise
present evidence of enhanced fibrinolysis compared with a mild increase of coagulation indices. However, whether there is
a favourable effect of exercise on fibrinolysis over coagulation and/or endothelial involvement during exercise needs to be
further investigated. |
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Keywords: | Aerobic exercise Essential hypertension Haemostatic disorders Endothelial function |
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